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Gardening Connection - Update 8/4/16 (UX Map and Prototype)

Partnering with a community garden can lead to new opportunities to connect with nature and people, to nurture others and oneself, to live!

Photo of Bettina Fliegel
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Who is your idea designed for and how does it reimagine the end-of-life experience?

A project that partners "at home hospice and at home palliative care" programs in urban areas with community gardens. Connecting one to nature, their families, and new people, working with a garden that provides healthy food to those that need it, can lead to self growth and enhance one’s life experiences through to the end of life. Might this also contribute to legacy, with a garden becoming a site that family and friends look to as a memorial after death?

A Palliative Care + Community Garden Partnership Project

Contents

The Premise

How Does Gardening Connection Work?

Program Users 

Benefits for Users

UX Map  (Update 8/4)

Prototype - Newspaper Blog Post  (Update 8/4)

Prototype/Brochure 

Timeline of Project Development to Date

Going Forward

Implementation and Scaling the Idea

References

________________________________________________________________________________________

THE PREMISE

Closeness to nature and working in a community garden amongst others can be therapeutic for patients in both palliative care and hospice programs.

The experience can provide:

  • A distraction.
  • An opportunity to interact with the natural world, stimulating the senses.
  • Reduction in pain perception and a decreased need for medication.
  • An opportunity to connect to new people, as well an opportunity to enrich the relationship with one's caretaker if they decide to participate in the project together.
  • An opportunity for families to share an activity that takes them out of the home, to an outside space where they can enjoy time together. They can also connect over gardening projects in the home.
  • An opportunity to continue to contribute to one's community.  How?  By creating sustainability.  By growing healthy food to share with those that need it. By contributing to the beautification of one's neighborhood.  By being present.
  • For caregivers - Working in a garden can help to decrease stress.  By report this may be rejuvenating for the fatigue which they experience.


On site hospices often have gardens that connect patients to nature.  Some sites have programming for patients that support them to work in the garden. Gardening Connection is for patients who are in at home programs and may not have exposure to gardens or nature.  It provides them with an opportunity to connect to community, nature and nurture themselves and others.  In the process they can continue to develop their identity and connect to new people, through to the end of life.

Might families forge stronger connections while participating in gardening activities and spending time in nature together, as a loved one approaches end of life?
Might the actions that a person carries out at the end of their life become part of their legacy that the family carries forward?  


THE PROGRAM - HOW DOES GARDENING CONNECTION WORK?  

This is a volunteer and hospitality program.  It ignites passion as it promotes wellness and community for patients receiving at home palliative care services.  Visiting nurses make referrals to the program for patients when they are caring for them in the home.

The program is flexible. There are a variety of opportunities for participation that one can move between as needed or desired.  Caregivers and family members are welcome and encouraged to participate in all aspects of the program. 

Each community garden is unique in set up and needs.  Participants will learn what they can do to support a local garden and their community.   

Possibilities for participation include:

At Home:  Plant and nurture seedlings that may later be transplanted in a garden.  One can participate alone, with a family member, or a caregiver.  Gardening Connection volunteers will assist you at home, to get you set up.  They will follow up with home visits, or by phone/Skype, to answer questions and share gardening tips! 

In A Garden:  Work on site in a garden side by side with garden members, family members, a caregiver, or with a designated volunteer garden buddy.  Volunteer work tasks may include: planting, watering, weeding, harvesting, maintenance of planters and other community garden needs.  Enjoying nature!

Visit a garden to relax, enjoy nature, and connect with others!

Participants can join community gatherings in a garden.  These may include cultural events and communal meals.

Each garden community is unique with it's own organization and structure.  Each one that would like to partner with Gardening Connection, to support and embrace their greater community, may consider how this might fit within their framework as they work to fulfill needs and towards goals.

The Idea has evolved based on feedback and insights from hospice nurses, a palliative care physician and community gardeners.   (See the original Mock Up Prototype -Brochure attached.)
The iterated program is focused on engaging families, to strengthen connections at end of life, if a patient wants that.  In addition it now offers hospitality as an option – spending time in a garden without working, in order to engage as many folk who would like to participate by simply spending time outside, connecting to others, in a garden.


Program Users

Patient

Visiting Nurse - As a referral source

Family Members - As co-participants.

Caregiver - As co-participant.

Garden Members and Garden Volunteers

Connector - Working for Gardening Connection as a volunteer.  Someone who volunteers or works for hospice with interest in gardening, or works in a garden and is interested in supporting patients.  They are the go to person for patient and gardeners.

Benefits for Users:

Patient - A path for urban at home palliative patients without access to nature to gain access.

Visiting Nurse - An opportunity to offer a patient a nature program that may ignite passion and wellness through to the end of life.

Caregiver -  A path for a caregiver in the city to access nature which can decrease stress, lessen fatigue.

Family - An opportunity for different generations living in a city to spend time together and create together.  An opportunity for one at the end of life to share values with family, building something with and for our community is important.   

Garden Members and Volunteers - An opportunity to extend programming to support vulnerable members within one's community.  An opportunity to bring new volunteers, patients and families, into the garden.  

Society - An opportunity to change the conversation on death and dying in our culture by bringing community members together on a regular basis, in a shared space where they interact in a natural way.


Update 8/4

User Experience Map  

Prototype - Newspaper Blog Post  (Related to the UX Map) 

Created to test the assumption:

Families will be eligible for garden membership, if desired, after participating as general garden volunteers over a period of time, as part of Gardening Connection Program with a loved one who was at EOL, and has now passed away.

One gardener I spoke to mentioned that in some gardens volunteers are asked to work for a period of time, doing general garden work - cleaning, fixing structures, guarding the garden when open to the public, before being considered for membership.  The prototype might be used to share with potential garden partners - How does the path to membership work with their garden?

______________________________________________________________________________________

PROTOTYPE/Brochure - Version 2.  - The prototype was created to test the assumption that palliative care providers, nurses and doctors, would find this program feasible and advantageous to their patients.  

The brochure can also be used to share with patients.  Does this program resonate with them?  Would they join?

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Timeline of Project Development through 8/3/16

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Going Forward

Continue to explore different community gardens.

Explore a local geriatric garden.  What are they doing?  Who is their referral source?  What services does the garden have for users?

Explore oversight organizations such as greenthumbnyc.org

Make contacts with garden Principals via monthly garden meetings.

Reach out to contacts received by by gardener to date.

Meet with home hospice nurses to discuss the idea.  


IMPLEMENTATION:  Incorporating Hospice Patients Into Existing Gardens

Short-time frame for implementation  

Reach out to local gardens as partners.  Assess accessibility.  Assess excitement for this project.                                                          

Long-time frame for implementation   

Update 8/3/16

Consider developing relationships within communities with clergy and community health centers as referral sources.

Explore bringing part of this program to inpatient hospice units that do not have gardens available.  Consider partnering with inpatient recreational therapists.

Update 7/17/16

Explore the idea of partnering with a community health organization or system to create a garden for a local community, building this Idea into the plan. Might this be a way to bring in extra services such as recreation therapists who would work with the patients in the garden?

Explore the role of this program for children receiving palliative care.

Scaling the Idea

Do a pilot project.  Iterate based on feedback and a needs assessment.  

Share the idea with oversight organizations and get their support to scale to other communities locally.  

Share best practices with other communities and organizations in the long term.


____________________________________________________________

References:

What Is the Evidence To Support The Role of Therapeutic Gardens For the Elderly?

Horticulture Sessions Help Hospice Patients   

Try Gardening to Balance Caretaker Fatigue

_____________________________________________________________

Thank you to the team for your input and feedback!

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Speak to palliative professionals regarding the feasibility of the idea.
Create a prototype to present to users.
Speak to a community gardeners and visiting nurses to see if they are interested in partnering on a project like this.
Speak to hospice patients, caregivers, and hospice volunteers to see if this interests them as well.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

Feedback from providers working with patients in palliative care and hospice programs.
Input from anyone with experience with community gardening.
Input from anyone with experience in horticultural therapy, or garden work in hospice settings.
Collaborators from these settings.

Tell us about your work experience:

I work in healthcare as a pediatrician. I have experience in inpatient, outpatient and emergency care settings as a clinician, teacher, and as an administrator. My experience has been primarily within underserved urban communities, most recently with adolescents in the juvenile justice system.

This idea emerged from

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Attachments (9)

Timeline .pdf

Timeline of project development, referencing work done and reflected in attachments here.

FEEDBACK V - Mt. Sinai, 2nd Visit.pdf

FEEDBACK V with Iterated Gardening Connection Program Description - July 30, 2016. 2nd Visit to Mt. Sinai Hospice Unit. Iterated Program, as reflected in the Prototype Iteration 2, reviewed with staff nurses.

Feedback IV - Conversations with Community Gardeners.pdf

Feedback IV - Conversations with community gardeners in NYC. Visits to two gardens. July 29 and July 31. Feedback and learnings.

Prototype Brochure - Iteration 2.pdf

PROTOTYPE 2 - Brochure - ITERATED Initial prototype/brochure iterated to reflect changes to how the Gardening Connection Program will work, based on feedback obtained from palliative care providers and community gardeners. (See Feedback II, III and IV.)

FEEDBACK III Hospice Nurse, MM.pdf

Feedback III - July 28, 2016 - Prototype Brochure shared with Hospice Nurse from Mt. Sinai Hospital. Feedback obtained on brochure and the program as described.

Feedback II Dr. Nelson.pdf

Feedback II - July 25, 2016 Meeting with palliative care physician, Jacobi Medical Center, Bronx, NY. Prototype/Brochure presented. Program discussed. Feedback obtained.

Brochure Mock Up July 27.pdf

PROTOTYPE - Gardening Connection Program Brochure (Initial Prototype)

FEEDBACK I Meeting, Mt. Sinai Hospice Nurses.pdf

Feedback I - Meeting with Mt. Sinai hospice nurses, July 14, 2016. Presented original idea using a rough diagram.

Rough Sketch_Process Diagram.jpg

Rough Sketch/ Process Diagram of Original Idea - Shared with hospice nurses, Mt. Sinai, July 14

46 comments

Join the conversation:

Comment
Photo of Lee-Jung Kim
Team

Bettina, I love the fact that you were able to gain insights from both the patient/caregiver side and the community involvement via community garden. It would be wonderful if we can pilot test this idea with some organizations willing to give this a try!

Photo of Bettina Fliegel
Team

Thanks Lee.  I learned a lot from visiting and speaking with a few gardeners.   Plus they were incredibly nice!  There is potential as there are 47 community gardens on the Lower East Side of Manhattan!  Apparently Fall is a busy season in the gardens.  There is a big festival - The Harvest Arts Festival.  Might be an opportunity to see several gardens.  
 (I just posted the feedback and learnings from the garden visits.)

Photo of Pearl Sequeira
Team

Bettina Fliegel - I agree with Lee-Jung Kim 's comments. I really love the insights you were able to gather from many perspectives, and look forward to hearing more about pilot(s) you can test! 

Photo of Lee-Jung Kim
Team

Bettina Fliegel I love the feedback that you got from Jacobi Medical Center! Our nurses matter team member Magdalena Kelleher sent a New Yorker Article today and I think everything is kind of coming together... http://www.newyorker.com/magazine/2016/07/11/the-work-of-a-hospice-nurse

I think it would be great to get family involved (if the patients have family members)...

Photo of Bettina Fliegel
Team

Thanks for the feedback. From the conversations I have had it seems that this program creates a way to bring families together in a meaningful way at EOL.  I will propose this as a path from the beginning.  This project will be all about flexibility, with different options to choose from and the ability to change paths along the way.

Thanks for sharing the article! 

Photo of Morgan Meinel
Team

Lee-Jung Kim This is such a beautiful article and really encompasses the essence of hospice care. Thanks so much for sharing it! 
Bettina Fliegel , I love the idea of getting family members and close friends involved. It's great to see your idea evolving. It has such great potential to create meaningful experiences for those who are ill and/or at the end of life. Interacting with the natural world and feeling a sense of community have such extraordinary benefits.

I also really love the potential long term goal of incorporating gardening activities on an inpatient Palliative/Hospice Care unit. Perhaps just having a volunteer from the program (either independently or in collaboration with an art therapist) visit the inpatient unit for a few hours a week or every other week and working with the patients and/or their families at the bedside. I love the image of that person having a seedling on their windowsill that they can watch grow each day. I think it's a really lovely idea.     

Please don't hesitate to let me know how the Mount Sinai team can be of further assistance during the refinement phase! :) 

Photo of Bettina Fliegel
Team

Thanks Morgan!

Photo of OpenIDEO
Team

Congrats on this being today's Featured Contribution!

Photo of Bettina Fliegel
Team

Thanks!

Photo of Anne-Laure Fayard
Team

Thanks Bettina for this update. Great prototype with the brochure!  Really interesting feedback. Do you think Dr. Nelson could contact the patient she mentioned and asked her if she would be interested? I'm sure we could find someone volunteering in a community garden who could work with her. It was really insightful to see how the program was seen by Dr. Nelson and I believe by some of the nurses of Mt Sinai as a potential connectors for families. I like the idea of having the option for participants to go the garden, even if it's not to work.

Photo of Bettina Fliegel
Team

Hi Anne-Laure.
Yes, I think several people see this Idea as a connector for families.  I will rethink that aspect.
I am going to add an option to spend time in the garden without working.  It makes sense!  (Not all working gardens are set up with rest areas, that I have seen, so I think it will be important to investigate what individual gardens have to offer before linking different patients to them.)  

One thing that Dr. Nelson said was that for home palliative care someone from the family, or a friend, must be actively involved with the patient's care.  She said they might not be the full time caregiver but there would be someone involved and interacting with services that come to the home, monitoring things etc.  Maybe this Idea becomes another of multiple services that home palliative care patients receive, but one that brings family together to focus on something other than medical care, either inside, or out of the house, on a regular basis?

If they take the patient to the garden for a few hours this also might function as some respite time for family, during which they can get some other things done?

Dr. Nelson asked to take the brochure with her to show to a colleague from the palliative care service.  She is going to get back to me later this week with feedback.  I can ask her about her patient then.  When we met she shared that her patient has a lovely and involved extended family.  Not sure how testing this would happen, if not part of an official program.

I hope to meet a community gardener soon as well.  Karine, from NYC OpenIDEO, put me in touch with someone! 

Photo of Pearl Sequeira
Team

Bettina! I thought of a similar idea as well! :)  

Given your experience with at-risk adolescents, I wonder if you can speak to the following. In my idea (which I did not post, given the similarity it shares with yours), I envisioned creating urban hospice gardens in at-risk neighbourhoods. Many large cities today  have a poverty reduction/elimination strategy, and access to food is a key issue. Imagine if as part of this strategy, green oases are created in at-risk neighbourhoods. 
The space can be divided into gardens and green cemeteries (via Bios Urns, https://urnabios.com/urn/). The gardens would be co-owned and co-managed by a community, including at-risk individuals (adolescents or recently released prisoners) together with patients, and the municipal government.
Vegetables and fruits can be grown in this space, and sold to local community centres and/or schools to prepare nutritious meals. Indoor plants can be grown, and sold to the general public to grow in their own homes. The proceeds of these sales would be invested back into the urban gardens, thereby sustaining its long term viability. 

Photo of Bettina Fliegel
Team

Hi Pearl.  
Thanks for your comment?  Like minds :) ?  I also am focused on urban communities but like the idea of gardens in whatever community needs them.  Some semi rural and suburban areas also have food insecurity so it would be great to have community gardens in those communities as well. 
Regarding the Bio Urns I had never heard of that.  It sounds interesting.  I am not sure that everyone in the community would want to use that burial method but perhaps it might be an option?  Is your idea that a garden should be a combination of food and cemetery?  I think it would be important to get user feedback on that, and also maybe do research as to whether something like this exists anywhere.  I think it might be hard to change a culture regarding families that embalm their loved ones.  
When it comes to urban gardens I am not sure there will be space for both side by side due to crowding in cities already.  I know that there is a big urban garden movement in Detroit and there seems to be more space in the city as many homes were abandoned and plots are vacant now.   Maybe that would be a place to test your idea? 
I was thinking of incorporating hospice patients as volunteers into existing gardens.  It would help to know who manages the different community gardens.  I know that some have volunteers come in from outside the community to help with work, but some are community based.  (so many variables to investigate.)  I like the idea of people at the end of life having the possibility to continue to contribute to something for others.   I am not sure they will be up to working in the garden so if not maybe they can grow seedlings in their homes to be replanted in the garden?   I think a garden might be a space that can become a memorial for their loved ones as they were involved there in some way, and maybe they would go there to remember them, or maybe even volunteer themselves as a way to honor their loved ones?  What do you think?

Creating an opportunity for work for those that were formally incarcerated is a really nice idea.  You might be interested in the work of the Doe Fund.  (I think it is a great organization.)  www.doe.org  
 I am not sure about teens at risk.  Do you mean after they have completed their education, or for those that have left school, both?  If it were an organized program with structure I think a gardening program might be great!  Another program that might interest you is The Green Bronx Machine.  It is one of the programs I was thinking about when I thought of this idea.  It is awesome!   https://www.ted.com/talks/stephen_ritz_a_teacher_growing_green_in_the_south_bronx?language=en
https://www.facebook.com/green.BX.machine/

Let's keep the conversation going!

Photo of Pearl Sequeira
Team

Bettina - I really like the updated version of the idea.  I've gone through your comments; please see below for my response. 

Bio-Urn Green  Cemetery:
I spoke to a few people in my network about the Bio-Urn green cemetery intertwined with urban green projects. I got mixed reactions to the idea; please see below for the feedback I received. This points to a cultural divide, which you mentioned in your comment. I believe this version of a cemetery could work if there is community buy-in.
Feedback:
- My runner friends/colleagues were not against it; they looked as 'urn' trees and gardens bringing new life into the space, and the opportunity to use the green space for citizen-led events such as Jane's Walk (http://janeswalk.org/) or Building Roads Together (https://farahwayglobal.com/building-roads-together/)
- My Jewish friends were against walking in a cemetery  because of religious customs associated with  visiting cemeteries.
 - Some of my Indian/Chinese colleagues were not very keen on the idea. (See the New York Times article on this:  http://www.nytimes.com/2014/12/09/us/cemetery-plan-clashes-with-neighbors-culture.html?_r=0) 
Finally, the idea about urban gardens in at-risk neighbourhoods, came from a couple of  sources:
-  article I read in the National Geographic Magazine (http://www.nationalgeographic.com/magazine/2016/04/nature-urban-national-parks/), and
-  Hult Prize finalist - Reel Gardening that tackles nutrition and gardening in urban slums, particular in South Africa (http://www.reelgardening.co.za/; https://www.changemakers.com/globalgoals2015/entries/reel-gardening)  
- Ron Finley's TED talk on urban gardening in South Central LA (https://www.ted.com/talks/ron_finley_a_guerilla_gardener_in_south_central_la?language=en) 

Incorporating Hospice Patients into Existing Gardens:
- I think the issue here is 'time to implement' and ease of coordination. Here are my suggestions - 
(i) For short-time frame for implementation - best to go with a structured approach where there is already community-buy in, and you can get a quick win
(ii) For medium-time frame for implementation - how about using community assets like  schools, as  a place to cultivate a garden, and a place for a community to come together (much like the Green Bronx Machine)
(iii) For long-time frame for implementation - how about using 'shared' assets like the roofs of buildings. Here the bigger issue is municipal zoning, and regulations on leasing a roof!

Creating opportunities for work:
 Thank you for introducing me to the Doe Fund. This is really cool! Re: Teens at-risk - I have no knowledge about working with at-risk youth. I threw in this idea, mostly because of your work experience with adolescents in the juvenile justice system. However, I just came across Pathways to Education for at-risk youth completing their education (https://www.pathwaystoeducation.ca/). The idea about incarcerated came from the work of Drive Change (http://drivechangenyc.org/).  

Photo of Bettina Fliegel
Team

Pearl,
Thanks for this amazing feedback and for reaching out to your network.  I will review the links and post back soon!
I really like the ideas about implementation based on a time frame.  Thanks for this great build!  I will update the post!

Photo of Bettina Fliegel
Team

Hi Pearl!  The Idea was Shortlisted into Refinement!  We are in Refinement!  I received an email from OpenIDEO explaining a few things about the process.  I would like to share it with you.  Can I email it to you?  Would you like to continue to collaborate, strategize and refine the idea?


I am going to meet with some hospice nurses this week at Mt. Sinai Hospital in NYC, facilitated by Morgan Meinel who works there as a nurse.  It has been organized by Lee Kim from the NYC OpenIDEO Chapter as she has been very busy organizing meet ups around their Idea - Nurses Matter Too.   I attended their last feedback session this past week.  
 
I am going to do some UX Mapping to bring to the meeting with the hospice nurses.  Potential Users in the Garden Connection  Project would be hospice patients, caregivers, garden volunteers and hospice volunteers.  I am not sure nurses would be playing a direct role.  Meeting with them will be great though because of their experiences with the patients.  I hope they can provide general feedback about patient needs, desires, and maybe ability for a project like this.  Who knows maybe one will be an avid gardener?  

Photo of Anne-Laure Fayard
Team

Hi Bettina, 

great idea and super happy you can get feedback on your idea from nurses at Mt Sinai. Lee mentioned this today and this is exciting. Looking forward to hearing what feedback you got.

I'm glad you got Pearl on your team. When I started reading your idea, it reminded of a post made by Pearl in the inspiration phase: https://challenges.openideo.com/challenge/end-of-life/research/green-spaces-and-legacies

I really like the idea and I think it addresses several aspects (and different actors: patients, family and nurses) of the end of life challenge. I'm wondering Bettina if you have access to a community garden in NY and connect with them to see if they would be willing to do a pilot. 

By the way, you might know about these resources but I found an article http://www.healinglandscapes.org/healthcare-gardens/ mentioning the Therapeutic Landscape gardens and they have a special article on community gardens: http://www.healinglandscapes.org/gardens/community.html

I was wondering if you could explain me the underlying rationale for the 3 steps for the implementation. I am not sure what is the added value of using the roofs rather than focusing on community gardens. 

Looking forward to getting the feedback of Thursday,

al

Photo of Bettina Fliegel
Team

Pearl,
Hi.  I have struggled with a name to represent this Idea.  What do you think of this current iteration - Gardening Connection?  Any other suggestions?

Photo of Pearl Sequeira
Team

Bettina - I like Gardening Connection.  Here are a couple of ideas  that hopefully tie in values of gardening and hospice/palliative care; hoping members from the OpenIDEO community can share their insights. 
- Garden of Connections
- Garden of Peace

Photo of Shane Zhao
Team

Love the new Gardening Connection title! Bettina, it's so great to hear you're meeting up with palliative care nurses at Morgan's hospital. Have you already met with them? Joanna Spoth We'd love to hear more about it and some of the feedback you received:)

Photo of Bettina Fliegel
Team

Shane andJoanna Spoth  - I am meeting nurses in the Hospice Unit at Mt. Sinai tomorrow.  (Lee Kim set up a meeting for all the NYC MeetUp Ideas.)  Looking forward to meetingMorgan Meinel and her colleagues at that time!   Will post after we meet. :)

Photo of Bettina Fliegel
Team

Thanks Pearl and Shane on the feedback re: the iterated Title!

Photo of Anne-Laure Fayard
Team

Hi, I love the new title too!

Shane Zhao Joanna Spoth one of our NYC OpenIDEO members Lee-Jung Kim  has been an amazing and passionate lead on this challenge. And Morgan Meinel has been a great support during the ideation, prototyping and now refinement phase. Bettina Fliegel we worked with Lee to create a feedback form to help participants tomorrow to give feedback in the short amount of time. I'm happy to help in editing it a bit for your idea. 

Photo of Anne-Laure Fayard
Team

Hi, I love the new title too!

Shane Zhao Joanna Spoth one of our NYC OpenIDEO members Lee-Jung Kim  has been an amazing and passionate lead on this challenge. And Morgan Meinel has been a great support during the ideation, prototyping and now refinement phase. Bettina Fliegel we worked with Lee to create a feedback form to help participants tomorrow to give feedback in the short amount of time. I'm happy to help in editing it a bit for your idea. 

Photo of Bettina Fliegel
Team

A-L,
Thank you!  That would be terrific.  I was going to write something to give them myself.  What are you thinking?  Can you email me the form that you have so I can see it?  I am going to present them  a very simple visual map.  I was then going to ask them using a feedback form  - "Is this a program you would refer patients to?  If yes why and if no, why not?"  I thought that might get at the heart of whether they find the Idea was appropriate for patients in early palliative care programs, and whether they felt patients desire and would benefit from something like this.   I was toying with adding  Question 2 - "If you were working as a nurse in a home hospice program would you volunteer for a Garden Connections program and if yes, why?" to get further info on what excites them about it?  
 What were you thinking?  What do you think about the 2 questions here?

The way I see the idea is that the Users are:
Patients
Garden staff and/or Garden Volunteers
Hospice Staff/Nurses/Volunteers as Referral Persons
 Hospice Volunteers - taking on a role as liaison between the garden and the patient for those doing at home gardening.
Caregivers -  as active participants, and also as liaisons between the garden and the patient who is doing at home gardening.  

Liaisons would do the following:  
For patients going to work in a garden they would -  Take patients to the garden and  help schedule them into work slot appointments.  

For patients doing "At Home Gardening", growing seedlings - Liaisons might, if needed,  set up an iPad or computer so that a garden volunteer or staff person can Skype with the patient.  During these Skype sessions they would give instructions on how to grow the seedlings,  check in to see how it is going,  follow up with further planning etc.  These virtual meetings would be weekly.  Contact could be more frequent if questions arise.

Home Visits - It would be great to have someone make home visits to those that are doing "at home gardening."  I wonder whether a new volunteer position could be developed - a Hospice/Garden volunteer who could take a leading role in the entire Idea.  (I will ask the nurses what they think about this as well.)

(I am meeting Lee at 5:15 before we meet the nurse group.  Any feedback you have would be great.)

Photo of Anne-Laure Fayard
Team

Hi Bettina, I can send you the questions we developed with Lee. But I think the 2 questions you have are great as they addressed both 1) will the idea have a positive impact on patients; 2) will they volunteer to support such a program. I guess the last question might be (if they reply positively to 1) is how would see this piloted in your hospital?  Or What would be a way to test this idea in your hospital? 
What might also come out is stories of similar programs that could be great sources of inspiration.

I love the option of home visit and skype calls for At home gardening. 

Cheers,

al

Photo of Anne-Laure Fayard
Team

Bettina Fliegel I also think that the idea of a simple visual map is a great way to present your idea and get feedback from them. Be ready to edit or create a new map "live" based on the feedback.
Looking forward to hearing how this evening session goes.
al

Photo of Bettina Fliegel
Team

Thanks for the feedback and the suggestion to be ready to iterate with map in hand.  I will cut up some copies of the one I make so they can push pieces around.  How does that sound?

Photo of Anne-Laure Fayard
Team

I love the idea of cutting pieces and supporting interactive feedback.
You can also have pens and different copies and invite people to draw / write  / annotate.

Looking forward to hearing how it goes (I wish I could be there!)

al

Photo of Bettina Fliegel
Team

Will do.  Thanks!!

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Team

So many exciting updates Bettina and AL! We love how all the NYC teams have been joining forces to help each other along the way. One helpful thing that we encourage all ideas to keep in mind is to go deep into one aspect of your idea vs going too broad — which we know you've already been doing with the feedback form and experience map. Perhaps that might mean you can focus on the Short-time frame for Implementation option. 

There are many features and unanswered questions each idea team is planning to tackle. Within the limited timeframe of Refinement, we'd love to see how each team might pick the most important aspect of their idea to focus on and test out. Definitely looking forward to all the progress to come!

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Team

Shane Zhao  What do you mean by the Short-time frame for implementation option?

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Team

Thanks Shane Zhao for the feedback and suggestions. Bettina Fliegel I believe Shane is suggesting to be focused in order to be able to do a pilot to test some of the assumptions. This is related to our yesterday conversation about focusing on one type of user.  

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Team

Thanks.  

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Team

Love this idea, Bettina! Since my challenge ended, I'm sad to say that I haven't made much progress on the idea. I'm really excited to see how your idea gets refined over time. I think the interview you did with the hospice nurses was really insightful. Have you had a chance to connect with any patients to get their input yet? Best of luck! 

Photo of Bettina Fliegel
Team

Hi Karen.  Thank you for the comment.  Nice to hear from you. Yes the feedback was very thoughtful and unexpected.  I thought Tomatero or an app like it might be a great and fun tool for kids, if the program includes kids.  Have you interacted with the sponsors?

No, I have not connected to patients about the idea. 

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Team

No, the sponsors never followed up after the challenge ended. A little disappointing, as I was hoping to get their involvement in the idea!

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Team

Bettina Fliegel Please add me to your team. I would like to offer help wherever possible. I had such a great time at Mt.Sinai yesterday! We learned so much during that short duration of time.

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Team

Welcome to the team, and thanks for all of your help so far!  Yes, it was a great learning experience.  I agree.

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Team

@bettina Fliegal More fun time to come!!!

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Team

Looking forward to seeing the idea evolved!

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Team

Really nice idea. Good luck with it! 

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Team

Thanks Simone!
I see you are from the UK but located in Nepal.  Do you have any thoughts on whether this idea might be welcomed and work in either location?  
How might this idea work in places where there is no formal end of life medical care, yet care is rendered by families in communities?  Do you think that connecting to nature and others via gardens, and contributing to sustainability at the end of one's life, might be a welcomed idea?

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Team

As I'm from the UK, it's easier for me to say with confidence that people in the UK would more likely welcome such an idea. From a personal perspective, I would loved to have been inspired in this way  when I lost my father. Unfortunately, there is very little emotional support at that time of need or alternatives. As for Nepal, the answer is much more complicated. The diversity of communities (ethnicity, religion, castes) all have their own traditions which would play an important role into how this was received. Nepal is a country with many beliefs and superstitions that would need to be further researched. However, as a farming country, I would be inclined to say that there would certainly be room to explore this. A friend recently lost her young child, I suggested that she could create a garden named after her daughter in the Herb Nepal farm for her memory. The gesture was welcomed and this would need to fit within her cultural traditions. Sorry, I can't provide more concrete information but these are my initial thoughts. Good luck.

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Team

Thanks Simone.
And Congrats!  to you and the team at Herb Nepal on your winning Idea in the Agriculture Innovation Challenge.  I read about it on the email blast OpenIDEO sent out yesterday.   Good luck developing the program! 

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Team

Welcome to the Refinement phase Bettina! Here are some key questions and milestones we encourage all idea teams to consider in the Refinement phase:

1. How might this idea address the unique needs of the target audience you're designing for?
2. Clearly summarize the value offering of your idea in 1-2 sentences
3. Communicate your idea in a visual way with user experience maps http://ideo.pn/UX_Map
4. Identify assumptions that need to be answered in order to validate your value offering: http://bit.ly/1Oi8ZHu
5. Collect feedback from potential partners and users to answer the assumptions you’ve identified.

Lastly, here's a useful tip: When you update the content of your post, it'd be helpful to indicate this in your idea title by adding an extension. For example, you can add the extension " - Update: Experience Maps 07/12" to you idea title. This will be a good way to keep people informed about how your idea is progressing!